Introduction: Remote symptom monitoring (RSM) allows patients to electronically self-report symptoms to their healthcare team for individual management. Clinical trials have demonstrated overarching benefits; however, little is known regarding patient-perceived benefits and limitations of RSM programs used during patient care.
Methods: This prospective qualitative study from December 2021 to May 2023 included patients with cancer participating in standard-of-care RSM at the University of Alabama at Birmingham (UAB) in Birmingham, AL, and the Univeristy of South Alabama (USA) Health Mitchell Cancer Institute (MCI) in Mobile, AL. Semi-structured interviews focused on patient experiences with and perceptions surrounding RSM participation. Interviews occurred over the phone, via digital videoconference, or in person, at the convenience of the patient. Grounded theory was used to conduct content coding and identify recurring themes and exemplary quotes using NVivo.
Results: Forty patients (20 UAB, 20 MCI) were interviewed. Participants were predominately female (87.5%), aged 41-65 (50%), and married (57.5%). Data is consistent with local demographics, comprising mainly White (72.5%) and 27.5% Black individuals. Three main themes emerged regarding perceived benefits of RSM: (1) Facilitation of Proactive Management, identifying the patient's needs and intervening earlier to alleviate symptom burden; (2) Promotion of Symptom Self-Management, providing patients autonomy in their cancer care; and (3) Improvement in Patient-Healthcare Provider Relationships, fostering genuine connections based on healthcare team's responses. However, participants also noted Perceived Limitations of RSM; particularly when support of symptom management was unnecessary, ineffective, or felt impersonal.
Conclusion: This study focused on patient experiences when utilizing a RSM program while undergoing treatment for cancer and found benefits to its implementation that extended beyond symptom management. At the same time, patients noted drawbacks experienced during RSM, which can help with future tailoring of RSM programs. Patient perceptions should be regularly assessed and highlighted for successful and sustained implementation.
Keywords: RSM; ePRO; implementation; perceived; relationship; remote symptom monitoring.
Cancer and its treatment can cause patients to experience many forms of symptoms. This can have a major effect on their overall well-being: physically, mentally, and emotionally. Early symptom detection and management has been shown to significantly improve the quality of life of patients with cancer. Remote symptom monitoring (RSM) allow patients to report their symptoms to their healthcare team and receive personalized feedback and management from them, without having to leave the comfort of their home. Although previous studies have shown the overarching benefits of implementing RSM during care, little is known regarding how patients perceive its implementation. This research team wanted to gain a better understanding of perceptions patients had, whether good or bad, of RSM’s implementation while they were actively undergoing cancer care. A total of 40 patients were interviewed with patients commenting on RSM’s ability to facilitate proactive management, promote symptom self-management, and improve patient-healthcare provider relationships. Patients also had feelings that under certain circumstances, RSM did have some limitations. This study was able to help identify some of the perceived benefits and limitations to RSM implementation. This feedback will not only help to ensure the successful implementation of future RSM programs but will also let patients know that they are heard and that their feedback is pivotal.